Facility-based individual models

Malawi facility fast track

Clinical
Specific populations
Context

Individuals who are stable ART clients are assessed by a nurse at the facility and enrolled in the six-monthly appointment programme (SMA). These clients are no longer required to see the clinician at each health care visit. The client goes directly to the SMA room in the facility run by health surveillance assistants (paid community health workers) to collect a 3-month ART refill from their repeat script. Clients are required to see the clinician twice a year for clinical review including re-scripting. Clients have their viral load taken once every two years at the facility using point of care viral load on the date of their clinical review. The result is assessed by the clinician as part of the clinical review.

Who is eligible for this model?

On ART >6 months, VL <1000, on 1st line ART, no ongoing OIs (including TB for 3 months), not pregnant or breastfeeding

ART refills

WHAT

ART refill
Adherence check
Brief symptom screen
Referral if unwell

WHEN

3 monthly

WHERE

Primary care clinic

WHO

Lay health care worker

Clinical consultation

WHAT

Laboratory tests (only every 2nd year)
ART rescripting
Clinical monitoring
ART refill

WHEN

6 monthly

WHERE

Primary care clinic

WHO

Nurse

Summary of the model (per year)

*POC VL every 2nd year

Location

Malawi fast track
Malawi

Need more details?

More information on how to implement this model.

More details